改良Bresler术治疗直肠前突合并直肠粘膜松弛的疗效评估  

The therapeutic efficacy evaluation of modified Bresler in the treatment of obstructed defecation syndrome associated with rectocele and rectal mucosal prolapse

作　　者：邓群[1] 刘智勇[2] 任华[1] 王健[1] 孙立峰[1] 丁克峰[1] 

机构地区：[1]浙江大学医学院附属第二医院肿瘤外科,杭州310009 [2]杭州市第三人民医院肛肠科,310009

出　　处：《中华结直肠疾病电子杂志》2017年第1期28-31,共4页Chinese Journal of Colorectal Diseases(Electronic Edition)

摘　　要：目的探索改良Bresler术治疗直肠前突合并直肠粘膜松弛的疗效。方法回顾性分析2014年1月至2015年6月浙江大学医学院附属第二医院及杭州市第三人民医院29例直肠前突合并直肠粘膜松弛患者,所有患者采用改良Bresler术治疗,即直肠后壁2/3用管型吻合器降落伞荷包的方法横向切除钉合,前壁1/3采用Bresler术纵向切除钉合粘膜,评价患者Wexner便秘评分、患者满意度以及术后6个月直肠前突情况。结果手术平均时间(31.1±5.5)min、术中平均出血量(16.3±7.5)ml、平均住院时间(7.2±1.3)d,术前和术后3、6个月,Wexner便秘评分平均值分别为(17.79±2.30)分、(6.71±1.18)分、(6.90±1.42)分;术前及术后6个月复查排粪造影,比较直肠前突情况,平均测量数值分别为:(3.6±0.4)cm、(0.7±0.2)cm,两者比较差异有统计学意义(t值=3.15,P<0.01)。结论改良Bresler术治疗直肠前突合并直肠粘膜松弛疗效确切、安全,但还需随机、多中心、大样本的临床试验去验证。Objective To study the therapeutic efficacy of modified Bresler procedure for the treatment of obstructed defecation syndrome（ODS） associated with rectocele and rectal mucosal prolapse. Methods A descriptive retrospective study from Jan 2014 to June 2015 was undertaken. 29 female patients with ODS caused by rectocele and rectal mucosal prolapse were treated with modified Bresler procedure. Results The average operation time is（31.1±5.5）min,the average intraoperative blood loss is（16.3±7.5）ml, and average postoperative hospitalization time is（7.2±1.3）days. The Wexner score of constipation before the operation is（17.79±2.30）, while the scores were（6.71±1.18） and（6.90±1.42） in three or six months after the operation. The defecography value before the operation is（3.6±0.4） cm,while the value is（0.7±0.2） cm in six months after the operation. The difference is significant（t=3.15,P 0.01）. Conclusion The modified Bresler procedure for the treatment of ODS associated with rectocele and rectal mucosal prolapse is safe and effective, but it still needs to be proved by a larger sample size study.

关 键 词：直肠 外科手术 Bresler术 出口梗阻型便秘 直肠前突 直肠粘膜松弛 

分 类 号：R657.1[医药卫生—外科学]